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PubMed2006

Total and inorganic arsenic in Mid-Atlantic marine fish and shellfish and implications for fish advisories.

Sampling was conducted in 2002 to determine the total concentration and chemical speciation of arsenic in several marine fish and shellfish species collected from the Delaware Inland Bays and the Delaware Estuary, both of which are important estuarine waterbodies in the US Mid-Atlantic region that support recreational and commercial fishing. Edible meats from summer flounder (Paralicthys dentatus), striped bass (Marone saxatilis), Atlantic croaker (Micropogonias undulates), and hard clam (Mercenaria mercenaria) were tested. Total arsenic was highest in summer flounder, followed by hard clam, then striped bass, and finally, Atlantic croaker. Total arsenic was higher in summer flounder collected during the spring, as these fish migrated into the Inland Bays from the continental shelf, compared with levels in summer flounder collected during the fall, after these fish had spent the summer in the Inland Bays. Similarly, striped bass collected in the early spring close to the ocean had higher total arsenic levels compared with levels detected in striped bass collected later during the year in waters with lower salinity. Speciation of arsenic revealed low concentrations (0.00048-0.02 microg/g wet wt) of toxic inorganic arsenic. Dimethylarsinic acid was more than an order of magnitude greater in hard clam meats than in the other species tested, a finding that was attributed to arsenic uptake by phytoplankton and subsequent dietary uptake by the clam. Risk assessment using the inorganic arsenic concentrations was used to conclude that a fish consumption advisory is not warranted.

Animals↗
PubMed2006

Influence of dissolved organic matter on acute toxicity of zinc to larval fathead minnows (Pimephales promelas).

We conducted laboratory toxicity tests in support of the development of a biotic ligand model (BLM) to predict acute toxicity of zinc (Zn) to fathead minnows (Pimephales promelas). To test the effect of dissolved organic matter (DOM) on Zn toxicity, we exposed larval fathead minnows to Zn in water containing elevated concentrations of dissolved organic carbon (DOC) in 96-h static-renewal toxicity tests. We tested DOM isolated from four surface waters: Cypress Swamp, Delaware; Edisto River, South Carolina; Suwannee River, Georgia; and Wilmington, Delaware, wastewater treatment effluent. The DOM isolates from the Edisto River and Wilmington wastewater treatment effluent contained elevated concentrations of NaCl (20-110x control NaCl) due to the use of a Na+-exchange resin to remove Ca2+ and Mg2+ during the DOM isolation process. Therefore, we also performed Zn toxicity tests in which we added up to 20 mM NaCl to exposure solutions containing Cypress Swamp and Suwannee River DOM. A threshold concentration of 11 mg DOC/L was needed to decrease Zn toxicity, after which the 96 h Zn LC50 was positively correlated with DOC concentration. Elevated NaCl concentrations did not alter Zn toxicity in the presence of DOM. In conjunction with data from other studies with fish and invertebrates, results of this study were used to calibrate Version 2.1.1 of the Zn BLM. BLM-predicted LC50s for our exposure waters containing elevated DOM concentrations were within the range of acceptable deviation relative to the observed LC50s (i.e., 0.5-2x observed LC50s); however, BLM-predicted LC50s for our exposure waters containing < 1 mg DOC/L were 2-3x lower than the observed LC50s (i.e., the BLM over-predicted the toxicity). Therefore, the current composite-species BLM for Zn could be improved for fathead minnows if that species were modeled separately from the other species used to calibrate Version 2.1.1.

Animals↗
PubMed1998

Effects of copper and zinc on embryos and larvae of the horseshoe crab, limulus polyphemus

We investigated the short-term and long-term effects of copper and zinc on horseshoe crab (Limulus polyphemus) embryos and first instar larvae from two estuaries in New Jersey, Delaware Bay and Sandy Hook Bay. Animals were exposed to nominal metal concentrations from 0.01 to 1,000 mg/L for 24 h, 48 h, 72 h, or continuously until the endpoint for the study (successful molting or death) was reached. Larvae showed greater tolerance of Cu and Zn than embryos. Under most treatment regimes, embryos and larvae were able to survive and molt in the presence of up to 100 mg/L Cu or Zn. Unexpectedly, horseshoe crabs from the more heavily polluted site (Sandy Hook Bay) were more susceptible to heavy metals than animals from a less polluted site (lower Delaware Bay). Horseshoe crab embryos and larvae were highly resistant to heavy metals in comparison to marine crustacea. The ability of Limulus embryos and larvae to survive in the presence of heavy metals implies the potential for these contaminants to be passed on to shorebirds and other predators.

Journal Article↗
PubMed1998

Developmental abnormalities in horseshoe crab embryos caused by exposure to heavy metals

We examined the effects of heavy metals on the development of horseshoe crabs using bioassays in which embryos at different stages were exposed either continuously or for 24 h. Abnormalities included segment-defective embryos, double embryos, embryos with abnormal eye areas, and no-posterior embryos. In terms of their ability to affect normal development, the pollutants are ranked as follows: Hg >== organotin > Cr falling dots Cd > Cu > Pb > Zn. Organotin treatment was associated with a high frequency of abnormal eye embryos and Hg with segment-defective embryos. The specific cause of segment-defective malformations by Hg was investigated by using SH inhibitors and cytochalasin B, an inhibitor of microfilaments. These inhibitors induced Hg-type segment-defective embryos; thus, Hg may also act by inhibiting SH-SS exchange and blocking morphogenetic movements. Horseshoe crab embryos from Delaware Bay and Sandy Hook Bay, New Jersey, were examined for developmental abnormalities. Malformed embryos were extremely rare (<0.6%) at five beaches along Delaware Bay as well as Sandy Hook Bay, suggesting that these horseshoe crab spawning areas are relatively unpolluted by heavy metals.

Journal Article↗
PubMed1996

Differences in young driver crash involvement in states with varying licensure practices.

Teenage driver licensing practices and the crashes of teenagers were compared in several states with differing laws and policies regarding licensure. High school seniors in Delaware, a state with laws that allow early driving and licensure, reported that they first drove on a public road, obtained a learner's permit and obtained a driver's license at younger ages than high school seniors in other northeastern states (Connecticut, New Jersey and upstate New York). State crash data indicated that Delaware and Connecticut, which allow unrestricted licensing at age 16, showed the highest rates of 16-year-old driver involvements in nonfatal and fatal injury crashes. Pennsylvania and upstate New York, which have night driving curfews for 16 year-olds, showed lower crash rates overall and much lower crash rates during their respective curfew hours. New Jersey and Nassau and Suffolk counties, where unsupervised driving by 16 year-olds is generally not allowed, showed the lowest crash rates for 16 year-olds. Graduated licensing programs that include delayed full-privilege licensure, night driving curfews, and extended periods of supervised practice driving are a possible countermeasure for the high motor vehicle crash rates of young drivers.

Accidents, Traffic↗
PubMed2006

Emergence of serine carbapenemases (KPC and SME) among clinical strains of Enterobacteriaceae isolated in the United States Medical Centers: report from the MYSTIC Program (1999-2005).

Among 8885 Enterobacteriaceae tested in the 1999 to 2005 period as part of the USA Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program, 51 strains with increased imipenem and meropenem MIC values (> or =2 microg/mL) were detected. bla(KPC) was identified from 28 Klebsiella pneumoniae from 3 medical centers in the New York City area (8 ribotypes), 2 Klebsiella oxytoca from Arkansas (same ribotype), 7 Citrobacter freundii (6 from New York [5 ribotypes] and 1 from Delaware), 4 Enterobacter spp. from New York (2 species, different ribotypes), 3 Escherichia coli (2 from New York and 1 from Ohio, same ribotype), and 1 Serratia marcescens (New York). Sequencing confirmed KPC-2 or -3 in all of the strains. S. marcescens strains harboring SME-1 (2 isolates, same ribotype) and SME-2 (1 isolate) were identified from medical centers in Illinois and Washington state, respectively. Our results indicate that bla(KPC-2/3) has emerged widely (New York City area, Arkansas, Delaware, and Ohio) among Enterobacteriaceae isolated in the MYSTIC Program participant sites (2000-2005) and continues to be isolated from multiple species, as a result of clonal expansion and horizontal gene transfer. The escalating occurrence (0.35%) of serine carbapenemases could compromise the role of carbapenems and other beta-lactams in USA clinical practice although observed in only a few locations to date.

Academic Medical Centers↗
PubMed2005

Identifying hydrologically sensitive areas: bridging the gap between science and application.

Researchers have noted that current water quality protection strategies, like nutrient management plans, lack a sound hydrological underpinning for pollutant transport processes. This is especially true for areas like the northeastern U.S. where copious research has shown that variable source area hydrology largely governs runoff generation. The goal of this study was to develop a scientifically justified method to identify the locations that generate overland flow. Furthermore, this methodology must be computationally simple enough that it can be utilized or incorporated into nutrient management plans and other established water quality tools. We specifically tested the reliability of the 'distance from a stream,'D(s), and the 'topographic index,'lambda, to predict areas with a high propensity for generating overland flow, i.e. hydrologically sensitive areas (HSA). HSAs were defined by their probability of generating runoff, P(sat), based on 30 year simulations using a physically based hydrological model. Using GIS, each location's P(sat) was correlated with D(s) and lambda. We used three Delaware Co., NY watersheds in the New York City watershed system with areas varying in size from 1.6 to 37 km2 and with forested and agricultural land uses. The topographic index gave stronger, more regionally consistent correlations with P(sat) than did D(s). Equations correlating lambda and P(sat) for each month are presented and can be used to estimate hydrological sensitivity in the region surrounding our study watersheds, i.e. in Delaware Co. This work is currently being incorporated into an Internet Mapping System to facilitate user-friendly, on-line identification of HSAs.

Conservation of Natural Resources↗
PubMed2002

Metal levels in horseshoe crabs (Limulus polyphemus) from Maine to Florida.

There is considerable concern for the health of spawning populations of horseshoe crabs (Limulus polyphemus) along the east coast of North America because of an increase in the harvest, an apparent decrease in population levels, and the dependence of migrating shorebirds on a superabundant supply of horseshoe crab eggs during their migratory stopover on Delaware Bay. In addition to overfishing, population declines could be caused or recovery slowed, by pollution. In this paper, we examine the levels of metals (arsenic, cadmium, chromium, lead, manganese, mercury, and selenium) in the eggs, leg muscle, and apodeme of 100 horseshoe crabs collected at nine sites from Maine to Florida. Arsenic levels were the highest, followed by manganese and selenium, while levels for the other metals averaged below 100ppb for most tissues. Arsenic and mercury levels were highest in the leg muscle; cadmium, lead, manganese, and selenium levels were highest in eggs; and chromium levels were highest in the apodeme. There were significant geographical differences for all metals in all three tissues. No one geographical site had the highest levels of more than two metals. Arsenic, with the highest levels overall, was highest in Florida in all the three tissues. Manganese levels were highest in Massachusetts for eggs and apodeme, but not leg, which was highest in Port Jefferson, New York. Selenium was highest in apodeme from Florida, and in eggs and leg muscle from Prime Hook, Delaware. The patterns among locations and tissues were not as clear for the other metals because the levels generally averaged below 100ppb. The levels of contaminants found in horseshoe crabs, with the possible exceptions of arsenic in Florida, and mercury from Barnegat Bay and Prime Hook, were below those known to cause adverse effects in the crabs themselves or in organisms that consume them or their eggs. Our results indicate that site-specific data are essential for managers to evaluate the potential threat from contaminants to both the horseshoe crabs and those that consume them.

Animals↗
PubMed2003

Ecological condition of US Mid-Atlantic estuaries, 1997-1998.

The Mid-Atlantic Integrated Assessment (MAIA-Estuaries) evaluated ecological conditions in US Mid-Atlantic estuaries during the summers of 1997 and 1998. Over 800 probability-based stations were monitored in four main estuarine systems--Chesapeake Bay, the Delaware Estuary, Maryland and Virginian coastal bays, and the Albemarle-Pamlico Estuarine System. Twelve smaller estuaries within the four main systems were also assessed to establish variance at the local scale. A subset of the MAIA-Estuaries data is used here to estimate the extent of eutrophication, sediment contamination, and benthic degradation in mid-Atlantic estuaries. An Environmental Report Card and Index of Environmental Integrity summarize conditions in individual estuaries, the four estuarine systems, and the entire MAIA region. Roughly 20-50% of the region showed signs of eutrophication (high nutrients, excessive production of organic matter, poor water clarity, or depleted dissolved oxygen), 30% had contaminated sediments, and 37% had degraded benthic communities. Compared with the Environmental Monitoring and Assessment Program (EMAP)-Virginian Province study in 1990-1993, larger fractions of Chesapeake Bay (17%) and Delaware River (32%) had increased metals or organics in sediments.

Biodiversity↗
PubMedDate not supplied

How pharmacists respond to on-line, real-time DUR alerts.

OBJECTIVE: To quantify the type and frequency of drug utilization review (DUR) alerts sent by one claims processor to pharmacists; identify how pharmacists respond to these on-line, real-time DUR messages; and quantify the interventions taken by these pharmacists as a result of these alerts. DESIGN: Retrospective analysis of Medicaid claims from July 1, 1995, through June 30, 1996. SETTING: State of Delaware. PARTICIPANTS: 55,000 Medicaid recipients served by 170 participating pharmacies and 2,000 physicians. INTERVENTIONS: All on-line DUR alerts sent to pharmacists and the pharmacists' responses were categorized by alert type and analyzed by drug class. MAIN OUTCOME MEASURES: Pharmacists' response (dispensed prescription, contacted prescriber, talked with patient, consulted own reference sources) and drug classes. RESULTS: During the study period, 807,017 claims generated 83,260 DUR alerts involving 73,554 (9.1%) prescriptions. Prescriptions were not dispensed in 20.9% of cases because of the DUR message. Prescriptions were dispensed 17.7% of the time after the pharmacist contacted the prescriber, in 20.6% of cases after the pharmacist talked with the patient, and 37.2% of the time after reviewing internal resources. Action taken by pharmacists varied among and within DUR criteria categories. Specific examples of alerts generated in high-frequency and high-profile areas are reviewed, some of which generated inconsistent responses. CONCLUSION: Among Delaware Medicaid providers, drug alerts resulted in pharmacists not dispensing prescriptions in a surprising percentage of situations. Pharmacists' responses varied according to the drug class involved and the type of alert received.

Drug Interactions↗
PubMed2006

Poly and perfluorinated carboxylates in North American precipitation.

Although perfluorocarboxylates (PFCAs) have been detected in a number of environmental matrices, there are very few reports on concentrations in precipitation. In this study PFCAs, fluorotelomercarboxylates (FTCAs), and fluorotelomer-unsaturated carboxylates (FTUCAs), were determined in wet only precipitation samples from nine sites in North America. The analytical method involved derivatization of the carboxylates and measurement of the 2,4-difluoroanilide by GC-MS. Samples from three remote sites in Canada had low concentrations of perfluorooctanoate (PFOA) (<0.1-6.1 ng/L). Significantly higher concentrations of PFOA were found at 4 northeastern United States and 2 southern urban Canadian sites, with Delaware having the highest levels (85 ng/L PFOA, with a range of 0.6-89 ng/L) and a maximum flux of 13 000 ng/m2. 8:2- and 10:2 FTCAs and FTUCAs were detected at all 4 U.S. sites and 2 urban Canadian sites (<0.07-8.6 ng/L), most frequently at the Delaware site. Longer chained PFCAs (deca-, undeca-, and dodeca-perfluorocarboxylates) were detected (<0.07-5.2 ng/L) at 2 urban Ontario sites but not determined in other samples. Air mass back trajectory results for 3 U.S. sites indicate highly populated urban areas in the New York to Washington corridor as the main sources of PFOA, although low PFOA levels associated with air masses coming off the Atlantic Ocean imply multiple sources.

Air Movements↗
PubMed2002

Transport, deposition and biodegradation of particle bound polycyclic aromatic hydrocarbons in a tidal basin of an industrial watershed.

Polycylic aromatic hydrocarbons (PAHs) are common contaminants in industrial watersheds. Their origin, transport and fate are important to scientists, environmental managers and citizens. The Philadelphia Naval Reserve Basin (RB) is a small semi-enclosed embayment near the confluence of the Schuylkill and Delaware Rivers in Pennsylvania (USA). We conducted a study at this site to determine the tidal flux of particles and particle-bound contaminants associated with the RB. Particle traps were placed at the mouth and inside the RB and in the Schuylkill and Delaware Rivers. There was net particle deposition into the RB, which was determined for three seasons. Spring and fall depositions were highest (1740 and 1230 kg of particles, respectively) while winter deposition was insignificant. PAH concentrations on settling particles indicated a net deposition of 12.7 g PAH in fall and 2.1 g PAH in spring over one tidal cycle. There was no significant PAH deposition in the winter. Biodegradation rates, calculated from 14C-labeled PAH substrate mineralization, could attenuate only about 0.25% of the PAH deposited during a tidal cycle in fall. However, in the spring, biodegradation could be responsible for degrading 50% of the settling PAHs. The RB appears to be a sink for PAHs in this watershed.

Biodegradation, Environmental↗
PubMed2003

Community health and nutrition screening for Special Olympics athletes.

Since 1961, Special Olympics has provided sports training and athletic competition for people with mental retardation. A recent addition to these Olympics has been the Healthy Athletes Program, designed to help the athletes improve their health and fitness, leading to enhanced sports experiences and well being. Original health services included dental and eye screening. In 2002, Special Olympics Delaware piloted a Wellness Park to add nutrition, blood pressure, and flexibility screening. Faculty from a university's health college trained discipline-specific students to conduct the screenings. Thirty nutrition and dietetics students measured height, weight, waist circumference, and calculated body mass index (BMI) for the athletes. Figures and risk-assessments were recorded on a "health report card." Two hundred ten athletes attended the nutrition screening. Ages ranged from 8 to 63 years; 81 percent males and 19 percent females. According to BMI standards, 32 percent of the athletes were overweight; 17 percent were obese. Twenty-five percent of adult males and 73 percent of adult females had a high risk waist circumference. Athletes at high risk for obesity-related diseases were referred to their primary physician for follow up. Nutrition education handouts included a simplified Food Guide Pyramid, tips for healthy eating in restaurants, 5 A Day information, and healthful hydration guides. Approximately 1,250 athletes participate in Special Olympics Delaware each year, providing a great opportunity to do some much needed health screening and improve access to health care for this often neglected population.

Adolescent↗
PubMed1990

Big and Little Moon Peyotism as health care delivery systems.

Big Moon Peyotism was introduced in the 1880s to the Delaware, Osage and Quapaw of Northeast Oklahoma by John Wilson, a Delaware-Caddo from Southwest Oklahoma. This form of Peyotism and the Little Moon ritual developed by the Apache, Kiowa, and Comanche of Southwest Oklahoma formed the basis of the two major variations of this religion as practiced by Native Americans throughout North America. An ethnographic and historic comparison of these religious traditions in Northeast Oklahoma presents these as health care delivery systems and highlights the importance of health care as a factor in the acceptance and persistence of Peyotism.

Health Services, Indigenous↗
PubMedDate not supplied

HIV/AIDS among probationers: an assessment of risk and results from a brief intervention.

A number of studies have examined HIV risk behaviors in prisoner populations, but relatively few have examined such behaviors in probationer populations. Since probationers have more opportunities to engage in risk behaviors than do prisoners, the potential importance of HIV interventions with probationers becomes readily apparent. This article examines a sample representative of the supervised probationer population in Delaware. The sample respondents received a baseline interview, then were randomly selected to receive either an enhanced version of NIDA standard HIV Intervention or a Focused Intervention based on a cognitive thought-mapping model. Intervention boosters were offered at two follow-up intervals in the following three months, and respondents were reinterviewed at six months. The data at baseline suggest that probationers in Delaware have levels of injection drug use, other serious drug use, and rates of risky sexual behaviors that approach those observed in prison populations. The interventions' effectiveness in changing attitudes and behaviors at the six-month interview was then examined. The data support the conclusion that brief interventions can significantly impact both drug use and sexual risk behaviors among probationers. However, there do not appear to be significant improvements for those receiving the more intensive Focused Intervention, as compared to those who receive the enhanced Standard Intervention. Further work will consider what components in programs and characteristics in clients should be considered in selecting the most appropriate interventions for probationers.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Toxicity and hazard of vanadium to mallard ducks (Anas platyrhynchos) and Canada geese (Branta canadensis).

A recent Canada goose (Branta canadensis) die-off at a petroleum refinery fly ash pond in Delaware was attributed to vanadium (V) toxicity. Because of the paucity of V toxicity data for wild birds, a series of studies was undertaken using the forms of V believed to have resulted in this incident. In 7-d single oral dose trials with mallard drakes (Anas platyrhynchos), the estimated median lethal dose (LD50) for vanadium pentoxide was 113 mg/kg body weight, while the LD50 for sodium metavanadate was 75.5 mg/kg. Sodium metavanadate was found to be even more potent (LD50 = 37.2 mg/kg) in male Canada geese. The most distinctive histopathological lesion of both forms of V was lympho-granulocytic enteritis with hemorrhage into the intestinal lumen. Vanadium accumulation in liver and kidney was proportional to the administered dose, and predictive analyses based on these data suggest that V concentrations of 10 microg/g dry weight (dw) in liver and 25 microg/g dw in kidney are associated with mortality (>90% confidence that exposure is >LD50) in mallards acutely exposed to sodium metavanadate. Chronic exposure to increasing dietary concentrations of sodium metavanadate (38.5 to 2651 ppm) over 67 d resulted in V accumulation in liver and kidney (25.2 and 13.6 microg/g dw, respectively), mild intestinal hemorrhage, blood chemistry changes, and evidence of hepatic oxidative stress in mallards, although some of these responses may have been confounded by food avoidance and weight loss. Dietary exposure of mallards to 250 ppm sodium metavanadate for 4 wk resulted in modest accumulation of V in liver and kidney (<5 microg/g dw) and mild intestinal hemorrhage. Based on these data and other observations, it is unlikely that chronic low-level dietary exposure to V poses a direct lethal hazard to wildlife. However, point sources, such as the V-laden fly ash pond encountered by geese at the petroleum refinery in Delaware, may pose a significant hazard to water birds.

Animals↗
PubMed1981

Effects of children's disabilities on parental time use.

An interview technique was used to collect data on the amount of time used in primary physical care of family members and in self-care of the mother. The amount of time that the mother was relieved of child care was also recorded, as was the frequency that families participated in certain activities. Children were first classified functionally according to their scores on the Vineland Scales of Social Maturity. The sample of 59 Delaware families interviewed was a subsample of an ongoing project currently being carried out at the University of Delaware. Analysis of the data included the analysis of variance and computation of Pearson's product-moment correlation and the chi-square test of independence. Although no difference was found between families with and without a disabled child as a member, families with a disabled child participated in fewer family activities than did families without a disabled child. Furthermore, significant correlations were found between the child's score on the Vineland Scales of Social Maturity and the amount of time the mother had for her self-care. Significant differences were found in the amount of personal care time available to the primary care giver and the disability classification of the child.

Adolescent↗
PubMedDate not supplied

Recommendations for managing vital-organ donors.

This chart describes some clinical problems organ donors may face, how the nurse should intervene, and the rationale for the intervention. The recommendations were developed by Corrinne Morgan, RN, CCRN, CNRN, for the Delaware Valley, Pa., transplant program, which serves eastern Pennsylvania, southern, New Jersey, and Delaware.

Brain Death↗